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Drinking water disinfection by-products (DBPs) are an unintended consequence of using disinfectants to kill harmful pathogens in drinking water. DBPs are formed by the reaction of disinfectants with natural organic matter (NOM) and bromide or iodide; precursors can also involve pollutants, such as pesticides, pharmaceuticals, antibacterial agents, estrogens, textile dyes, bisphenol A, parabens, surfactants, and algal toxins. In addition, DBPs can be formed in swimming pool water. Eleven DBPs are currently regulated in the United States, but more than 600 have been identified. Human health concerns include bladder cancer, miscarriage, and birth defects in drinking water and also asthma from heavy exposure to indoor swimming pools. Emerging, unregulated DBPs include halonitromethanes, iodo-trihalomethanes, iodo-acids, haloamides, halofuranones, haloacetonitriles, nitrosamines, and halobenzoquinones. Many of these unregulated DBPs are more genotoxic or cytotoxic than those currently regulated. This proceedings chapter discusses these issues, along with precursors and mechanisms for the formation of this next generation of DBPs, as well as new links with epidemiology.

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